【摘要】 目的 总结血管腔内覆膜支架植入术治疗腹主动脉瘤患者围手术期并发症的预防、观察和临床护理要点。 方法 对2008年1-8月行血管腔内覆膜支架植入术治疗的27例腹主动脉瘤患者的临床资料进行回顾性分析。 结果 27例手术均获成功，术后未发生严重并发症，治疗及护理效果良好。 结论 有效的护理措施是保证治疗成功的重要因素。【Abstract】 Objective To summarize and analyze the prevention, observation and clinical care of perioperative complications in patients with abdominal aortic aneurysm (AAA). Methods We retrospectively analyzed the clinical data of 27 patients with AAA who underwent endovascular covered stent grafting surgery in our hospital from January to August 2008. Results With appropriate treatment and good care, all grafting surgeries were successful without any severe postoperative complications. Conclusion Effective care measures are an important factor to ensure successful treatment.
目的：评价电子气管镜直视下置入镍钛合金支架治疗气道狭窄的疗效及安全性。方法：对我院3年来由各种原因引起的气管或支气管狭窄的21例患者行电子气管镜直视下经鼻置入国产镍钛合金支架术，观察置入支架前后症状、狭窄段气道直径变化、动脉血气变化情况及其并发症。结果：21例患者术后呼吸困难均明显改善，气道内径扩张及动脉血氧分压改善较术前均有统计学意义，未发生严重并发症。结论：电子气管镜直视下置入气道支架准确、迅速、安全，操作较方便，有助于延长患者的生存时间和提高生活质量，为进一步治疗创造条件。
ObjectiveTo investigate the clinical effect of biliary stent implantation through T-tube lumen and nasobiliary drainage through intrahepatic bile duct in the treatment of biliary leakage after biliary tract exploration.MethodsRetrospective analysis was performed on the clinical data of one case of bile leakage after common bile duct exploration admitted to the Department of Hepatobiliary Surgery of Nanchong Central Hospital in December 2016.ResultsIn this case, the biliary stent was placed in the T-tube lumen and the nasal bile duct was placed in the intrahepatic bile duct for biliary drainage. The guidewire was inserted into the hilum of liver through the tunnel in the T-tube cavity, and nasobiliary drainage was placed to the hilum of liver. In addition, a guide wire was inserted through the T-tube into the duodenum, and a 8.5F plastic stent was placed into the duodenum. One end of the stent was placed in the common bile duct, and the other end was placed in the intestinal cavity for biliary drainage. After drainage, the patient’s bile leakage stopped and the abdominal infection was controlled. Ten days after the biliary stent implantation, the patient was discharged successfully, the T-tube and nasobiliary duct were clamped 20 days after the surgery, and T-tube angiography and abdominal B-ultrasound were performed 2 months later, and it found that the scaffold of the lower common bile duct had fallen off, so removed the T-tube. The patient recovered completely after 2 years of follow-up.ConclusionThe means of T-tube tunnel biliary stent and the nasobiliary duct drainage through the intrahepatic bile duct are effective methods to treat biliary leakage, the operations are simple and easy to operate.
To explore the influence of bionic texture coronary stents on hemodynamics, a type of bioabsorbable polylactic acid coronary stents was designed, for which a finite element analysis method was used to carry out simulation analysis on blood flow field after the implantation of bionic texture stents with three different shapes (rectangle, triangle and trapezoid), thus revealing the influence of groove shape and size on hemodynamics, and identifying the optimal solution of bionic texture groove. The results showed that the influence of bionic texture grooves of different shapes and sizes on the lower wall shear stress region had a certain regularity. Specifically, the improvement effect of grooves above 0.06 mm on blood flow characteristics was poor, and the effect of grooves below 0.06 mm was good. Furthermore, the smaller the size is, the better the improvement effect is, and the 0.02 mm triangular groove had the best improvement effect. Based on the results of this study, it is expected that bionic texture stents have provided a new method for reducing in-stent restenosis.
Objective To review the research progress of electrospun nanofibers scaffold in nerve tissue engineering. Methods The related l iterature on electrospun nanofibers scaffold in nerve tissue engineering was extensively reviewed and analyzed. Results A variety of material nanofibers scaffolds can be fabricated through electrospinning. The chemical and physical properties of the scaffold can be modified and it was suitable for neuron. The scaffold can bridge the defect of peripheral nerve and partial function can be restored. Conclusion Electrospun nanofibers scaffold has broad appl ication prospects in nerve tissue engineering.
ObjectiveTo explore a method of three-dimensional (3D) printing technology for preparation of personalized rat brain tissue cavity scaffolds so as to lay the foundation for the repair of traumatic brain injury (TBI) with tissue engineered customized cavity scaffolds. MethodsFive male Sprague Dawley rats[weighing (300±10) g] were induced to TBI models by electric controlled cortical impactor. Mimics software was used to reconstruct the surface profile of the damaged cavity based on the MRI data, computer aided design to construct the internal structure. Then collagen-chitosan composite was prepared for 3D bioprinter of bionic brain cavity scaffold. ResultsMRI scans showed the changes of brain tissue injury in the injured side, and the position of the cavity was limited to the right side of the rat brain cortex. The 3D model of personalized cavity containing the internal structure was successfully constructed, and cavity scaffolds were prepared by 3D printing technology. The external contour of cavity scaffolds was similar to that of the injured zone in the rat TBI; the inner positive crossing structure arranged in order, and the pore connectivity was good. ConclusionCombined with 3D reconstruction based on MRI data, the appearance of cavity scaffolds by 3D printing technology is similar to that of injured cavity of rat brain tissue, and internal positive cross structure can simulate the topological structure of the extracellular matrix, and printing materials are collagen-chitosan complexes having good biocompatibility, so it will provide a new method for customized cavity scaffolds to repair brain tissue cavity after TBI.
Objective To establish a model for studying on mechanical responses of osteoblasts seeded in 3 dimensional(3D) scaffold. Methods Fifty pieces of bioderived cancellous bones, whose holes were 500 to 800 μm and density was 0.36 to 0.45g/cm3, were obtained as the scaffolds. They were cultured with the third passage suspension of Wistar rat. Twenty-four of the 50 scaffolds were constructed under apparent strain sine waveform with amplitude of 1 000 με, frequency of 3 Hz, and duration of 3 min/d, as experimental group. The other scaffolds were control group. After 3day coculture, osteoblasts were observed with scanning electron microscope. The proliferation of the osteoblasts was checked by MTT on scheduled date. Results Scanning electron microscopic observation showed that osteoblasts ttached and spread on the trabeculae, which presented the validity of the model under proper mechanical condition. Experiment showed that mechanical environment promoted theproliferation of osteoblasts. The observation of proliferation of osteoblasts showed that the quantity of osteoblasts in the experimental group was higher than that in the control group 1,4,8,12,16,20,24, and 28 days after culturing. Therewas significant difference between the two groups 12,16,20,24,and 28 days afterculturing(P＜0.05). Conclusion The establishment of the model can facilitate the study of mechanical responses of osteoblasts under different conditions.
Objective To investigate the security and efficiency of endovascular repair for Stanford type B aortic dissection (AD) with severe complications. Methods Between January 2003 and December 2009, 60 patients having Stanford type B AD with severe compl ications were treated, including 39 males and 21 females with an average age of 43.7 years (range, 34-71 years). Severe compl ications included 27 cases of huge hemothorax, 1 case of paraplegia, 7 cases of acute renal failure,10 cases of cel iac trunk ischemia, 10 cases of superior mesenteric artery ischemia, and 5 cases of severe limb schemia. Emergency stent-graft deployment were appl ied in all patients, and 64 stent-grafts were successfully implanted. Results All patients survived and were followed up 3-86 months. Hemothorax disappeared after 28 days to 3 months of operation in all hemothorax patients; renal function returned normal after 1 to 9 days; l imb and visceral ischemia disappeared gradually after 1 to 14 days; and muscular strength of lower limb in the paraplegia patient began to recover after 4 hours of operation. The postoperative CT angiography showed enlarged true lumen and thrombosis in the false lumen. Conclusion Emergency endovascular repair is a safe and effective method to treat Stanford type B AD with severe complications.
ObjectiveTo summarize the research progress of several three-dimensional (3-D) printing scaffold materials in bone tissue engineering. MethodThe recent domestic and international articles about 3-D printing scaffold materials were reviewed and summarized. ResultsCompared with conventional manufacturing methods, 3-D printing has distinctive advantages, such as enhancing the controllability of the structure and increasing the productivity. In addition to the traditional metal and ceramic scaffolds, 3-D printing scaffolds carrying seeding cells and tissue factors as well as scaffolds filling particular drugs for special need have been paid more and more attention. ConclusionsThe development of 3-D printing porous scaffolds have revealed new perspectives in bone repairing. But it is still at the initial stage, more basic and clinical researches are still needed.